Feds concerned after 360k Florida kids lose Medicaid, CHIP coverage

Department of Health and Human Services Secretary Xavier Becerra said in a letter to Gov. Ron DeSantis on Monday that he is “deeply alarmed” by the number of children who lost coverage after the end of a COVID-era policy that banned states from dropping people from Medicaid.

Becerra urged Florida and eight other states with the nation’s largest coverage losses to make it easier for eligible people to maintain their insurance. States that are determined to shrink Medicaid rolls during the post-COVID “unwinding” process, as Florida is, are supposed to help shift eligible children to the Children’s Health Insurance Program (CHIP), but federal officials say more must be done to guide those transfers.

In total, over 800,000 Florida residents have been removed from the state’s Medicaid program from March to September. About half of all terminated Floridians lost coverage for procedural reasons such as failing to update their contact information.

“Because all children deserve to have access to comprehensive health coverage, I urge you to ensure that no child in your state who still meets eligibility criteria for Medicaid or CHIP loses their health coverage due to ‘red tape’ or other avoidable reasons,” Becerra wrote in his letter to DeSantis.

Gov. Ron DeSantis’ office forwarded the Orlando Sentinel’s request for a response to the Florida Agency for Health Care Administration and Florida Department of Children and Families (DCF).

DCF spokesperson Mallory McManus said the agencies are working on a reply to Becerra’s letter.

“A reminder that the Medicaid redetermination process is simply setting normal operations back in motion, like how it was before the pandemic, to ensure those accessing a safety net program in our state are those who truly qualify,” McManus wrote in an email.

But organizations like the Florida Policy Institute, a nonprofit policy advocacy group, say this process is far from normal: It is a “crisis.”

“There is a child health insurance crisis that has unfolded in Florida over the last six months,” reads a statement from Florida Policy Institute CEO Sadaf Knight. “We strongly urge Gov. DeSantis to implement common-sense recommendations as outlined [by] Secretary Becerra, and as outlined by Florida health and child advocacy groups, that would preserve coverage for Florida children and ensure they have access to life-saving medications and care.”

Becerra said in his letter that the federal government has offered states dozens of policy modifications to make renewals easier for people. As of Monday, Florida is the only state that hasn’t opted into any of them.

The federal government has the authority to request that states pause terminations. Becerra noted in his letter HHS will “not hesitate” to “take action” if needed.

Governors from Arkansas, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas received letters as well.

“HHS takes its oversight and monitoring role during the renewals process extremely seriously,” he wrote.

Other efforts by Florida to keep kids insured have also hit obstacles.

Earlier this year, Florida lawmakers voted to expand income limits for KidCare, the state’s children’s health insurance program for kids whose families make too much to qualify for Medicaid. But a paperwork snafu has pushed the anticipated start date from Jan. 1 to April 1, officials announced in a conference earlier this month.

Florida also committed to postpone dropping coverage for medically complex kids under 21 until the end of the Medicaid unwinding in Spring 2024, but families have shared that their kids lost coverage despite falling into that category.

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Last week, a U.S. district judge in the Middle District of Florida heard arguments in a class action lawsuit accusing the state of failing to give proper notification to people losing coverage. The suit, pursued by the National Health Law Program and Orlando-based Florida Health Justice Project, seeks to restore coverage to some of the people who were dropped.

Florida is also one of ten states that chose not to expand Medicaid, a program jointly funded by the state and federal government.

Medicaid expansion would give the state up to $5 billion in federal money to serve 1.5 million more people, according to Healthinsurance.org, an independent guide for the health insurance marketplace.

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On top of this, Florida recently overhauled the online portal where people apply for and update their Medicaid information. State officials said the revamped website would make it easier to upload documents and access the site on mobile platforms, allow people to reset and recover passwords through email and text, and provide a more efficient and secure system.

Prior to the new website’s rollout on Dec. 5, health care advocates expressed concern this would add additional barriers for people without easy access to technology and exacerbate the long wait times that have plagued the Medicaid renewal process.

Third-party advocacy groups have not publicly critiqued the portal’s performance so far, but residents are flooding Florida DCF’s social media pages with comments saying they’ve had problems creating new accounts and transferring their information.

Two days after the portal’s rollout, DCF spokesperson McManus pointed to a new call center created to help people navigate the switch, which had an average wait time of 4 minutes: 833-912-2575.

As of Friday, more than 462,000 new accounts have been created, McManus said.

Ccatherman@orlandosentinel.com; @CECatherman Twitter

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